Table 1 A Comparison of Orthopaedic and Internal Medicine Program Directors’ Perceptions of the USMLE Step 1 Pass/Fail Transition: Likert Scale Responses

How do orthopaedic and internal medicine program directors feel about the pass/fail Step 1?

0 = strongly disagree, 1 = disagree, 2 = neutral, 3 = agree, 4 = strongly agree

 I agree with the change to pass/fail Step 1

0.0 (1.0)

1.0 (2.0)

0.313

 The decision to transition to pass/fail Step 1 was transparent and adequatelyinvolved all stakeholders

1.0 (1.0)

0.0 (1.0)

0.412

 A graded Step 1 adequately measured the ability of an applicant to succeed

2.0 (1.0)

2.0 (2.0)

0.574

How will a pass/fail Step 1 impact orthopaedic and internal medicine residency programs?

0 = strongly disagree, 1 = disagree, 2 = neutral, 3 = agree, 4 = strongly agree

 A pass/fail Step 1 will make the match process fair and meritocratic

2.0 (2.0)

1.0 (2.0)

0.028*

 A pass/fail Step 1 will help to create better future physicians

2.0 (2.0)

1.0 (2.0)

0.211

How will the pass/fail change impact the importance of the factors reviewed by orthopaedic and internal medicine residency programs when assessing applicants?

0 = significantly less important, 1 = less important, 2 = no change, 3 = more important,4 = significantly more important

 Step 1 exam result

0.0 (1.0)

1.0 (2.0)

< 0.001*

 Step 2 CK

4.0 (1.0)

4.0 (1.0)

0.159

 Step 2 CS

2.0 (1.0)

2.0 (1.0)

0.423

 Grades in required clerkships

3.0 (1.0)

3.0 (1.0)

0.060

 Research experience

2.5 (1.0)

2.0 (0.0)

< 0.001*

 Letters of recommendation from orthopaedic/internal medicine faculty thatprogram directors know

3.0 (1.0)

3.0 (1.0)

< 0.001*

 Letters of recommendation from orthopaedic/internal medicine faculty thatprogram directors do not know

3.0 (1.0)

2.0 (1.0)

0.103

 Letters of recommendation from faculty not within specialty

2.0 (0.0)

2.0 (0.0)

0.350

 Personal statement

2.0 (0.0)

2.0 (0.0)

0.665

 Medical student performance evaluations (MSPE)/Dean’s letter

2.0 (1.0)

3.0 (1.0)

0.120

 Alpha Omega Alpha (AOA) membership

3.0 (2.0)

2.0 (1.0)

< 0.001*

 Gold Humanism Society membership

2.0 (1.0)

1.0 (1.0)

0.069

 Leadership/extracurriculars

3.0 (1.0)

2.0 (1.0)

< 0.001*

 Personal knowledge of applicant

4.0 (1.0)

3.0 (2.0)

< 0.001*

 Audition electives within department

4.0 (1.0)

3.0 (1.0)

< 0.001*

How will various applicant groups be affected by the change to a pass/fail Step 1?

0 = greatly disadvantaged, 1 = disadvantaged, 2 = neutral, 3 = advantaged, 4 = greatlyadvantaged

 All MD students

2.0 (1.0)

2.0 (1.)

0.098

 MD students who attend a highly-regarded medical schools

3.0 (2.0)

3.0 (1.0)

0.599

 MD students who do not attend a highly-regarded medical school

1.0 (1.0)

1.0 (1.0)

0.011*

 DO students

1.0 (2.0)

1.0 (1.0)

0.001*

 International medical graduates (IMGs)

1.0 (2.0)

1.0 (1.0)

0.146